Researchers Find New Clues to Treat Rare and Aggressive Inflammatory Breast Cancer

Massimo Cristofanilli, M.D.

A study led by investigators from Thomas Jefferson University’s Kimmel Cancer Center has discovered molecular clues that may help physicians therapeutically target inflammatory breast cancer (IBC), a highly aggressive form of breast cancer.

Their study, reported in the June 21 online issue of Breast Cancer Research and Treatment, identified two molecules (ALK and FAK1) involved in the IBC cancer pathway. Drugs already exist that inhibit both of these two cancer-promoting proteins at the same time, which the researchers are now testing in animal preclinical studies.

“Women diagnosed with inflammatory breast cancer are in great need of therapies that are tailored to this aggressive form of breast cancer. Survival rates are much lower than for other forms of breast cancer,” says the study’s lead author Sandra V. Fernandez, Ph.D., Assistant Professor in the Medical Oncology department at Jefferson.

IBC is a particularly aggressive and highly metastatic form of breast cancer characterized by very rapid onset of progression— weeks to a few months — and metastasis that spreads quickly to the brain, bones, and soft tissues. The three-year survival rate is 40 percent for IBC patients compared with 85 percent in other forms of breast cancer. Additionally, IBC patients are younger when diagnosed.

The disease is also difficult to diagnose because it appears as redness and swelling of the breast. There are no classic tumor masses.

“Because of how this cancer looks, physicians often think it is dermatitis, or inflammation, or an infection, such as mastitis. I know of many patients who were misdiagnosed from the start, and by the time they were referred to an oncologist, their cancer had progressed,” says the study’s senior investigator, Massimo Cristofanilli, MD, FACP, Professor of Medical Oncology and Director of the Jefferson Breast Care Center.

“We need to improve both diagnosis and treatment of this cancer, which is on the rise for reasons that are not understood,” he says.

The advances reported in the study were possible because the research team developed a new animal model of IBC, derived from tumor  cells from a patient with metastatic triple negative (estrogen receptor-negative, progesterone receptor-negative, Her2-negative) inflammatory breast cancer under an IRB-approved study. At the present, there are few animal models to study this particular disease.

In addition to identifying some of the pathways involved in IBC, the researchers were able to characterize the pattern of spread of the disease, which moved quickly to organs and the brain. They found that clumps of the cancer — not tumor masses — obstruct lymphatic channels in the breast, causing the swelling of breast tissues.

“This animal model is a really important tool to use to study IBC progression and metastasis, and to test potentially beneficial drugs,” says Dr. Fernandez.

Researchers from the University of Texas M D Anderson Cancer Center and Fox Chase Cancer Center contributed to the research.

The study was supported by the American Airlines-Komen for the Cure Foundation Promise Grant KGO81287, NIH NCI 1R01 CA 138239, and the Inflammatory Breast Cancer Foundation.

The authors declare that they have no conflicts of interest.

For more information, contact Jackie Kozloski, 215-955-5296, jackie.kozloski@jefferson.edu.



Jefferson’s Kimmel Cancer Center Establishes Center to Eliminate Cancer Disparities

Dr. Edith Mitchell, director of newly-established Center to Eliminate Cancer Disparities, and Robin Evans, a patient.

PHILADELPHIA—In an effort to reduce and eventually eliminate cancer disparities among adults in the Philadelphia region, the Kimmel Cancer Center at Jefferson has established the Center to Eliminate Cancer Disparities.

Edith P. Mitchell, M.D., FACP, a medical oncologist at Thomas Jefferson University Hospital and Clinical Professor of Medicine and Medical Oncology in the Department of Medical Oncology at Jefferson Medical College of Thomas Jefferson University, will serve as its Director.

Despite the decline in cancer incidence and mortality rates in the United States, disparities in cancer burdens continue to exist among certain population groups and the gap continues to widen.  The Philadelphia region in particular has a disproportionately high number of residents suffering from cancers, many of which are preventable and treatable.

Such disparities include differences in incidence, prevalence, mortality and burden of cancer and related adverse health conditions. Disparate population groups may be characterized by gender, age, race and ethnicity, income, social class, disability, geographic location or sexual orientation.

“I have dedicated my career to the treatment of cancer patients and have had the opportunity to experience, as a physician and as a researcher, the significance cancer disparities can have on the outcome of a patient’s treatment,” said Dr. Mitchell. “The first step in the elimination of these disparities is to raise awareness through public and professional education about what resources are available to groups in their fight against cancer.”

The Center aims to accomplish its mission through the facilitation of disparities-focused research, researcher and clinician education, training and teaching, and increased patient access to quality supportive services, such as palliative care, cancer screening and prevention, and survivorship programs.

Dr. Mitchell and her fellow clinicians and researchers at Jefferson are dedicated to the ongoing study of cancer and other health disparities among patients of diverse ethnic and socioeconomic backgrounds. They have created strategic priorities for eliminating such disparities through innovative research, education and training, advocacy, community outreach, and quality medical care.

The need for research into cancer, and other health care disparities, has become increasingly evident in recent years as doctors and scientists learn more about how slight variations in genetic makeup can have drastic effects on the way cancer invades an individual’s body.  Knowing that these disparities exist can improve how screening processes are established and help doctors understand which treatments will and will not be effective.

Dr. Mitchell has spent her medical career helping individuals in medically underserved areas to realize that simple changes in lifestyle can have a dramatic impact on cancer care. Through her work, Dr. Mitchell has demonstrated the importance of community service and outreach especially to those individuals who may not have the means to seek out more conventional medical advice.

She holds board certifications in both Internal Medicine and Medical Oncology and is a Fellow in the American College of Physicians. She has also served as the Program Leader in gastrointestinal oncology for more than 15 years and has a focused research effort in aggressive breast cancers.

“We want all researchers and clinicians to be aware of the disparities that exist in cancer diagnoses among diverse ethnic groups so that they can incorporate these important factors into their research efforts and clinical practice,” said Dr. Mitchell.

“The Center will also provide patients with contact information for cancer advocacy and support groups both locally and nationally that serve the needs of their demographic background. We are proud to host and sponsor several annual events where patients can come together to share their stories and plan for a future free of cancer disparities,” she said.



Edith Mitchell Receives ‘Practitioner of the Year’ Award from Philadelphia County Medical Society

Edith Mitchell, M.D.

Edith Mitchell, M.D., clinical professor of Medicine and Medical Oncology at Jefferson Medical College of Thomas Jefferson University, was named 2011 “Practitioner of the Year” Award by the Philadelphia County Medical Society (PCMS).

For her excellence in clinical care and community service, Dr. Mitchell will be presented the award on Saturday, June 11, during the PCMS President’s Ball at the Ace Conference Center in Lafayette Hill, Pa., celebrating the installation of its 150th president.

“For over 165 years, this society has been advocating for the best in healthcare for all the citizens of Philadelphia,” said Dr. Mitchell, who is also Associate Director for Diversity Programs at the Kimmel Cancer Center at Jefferson. “It’s a great honor to be part of those efforts and recognized for it with this award.”

Dr. Mitchell has spent her medical career helping individuals in medically underserved areas to realize that simple changes in lifestyle can have a dramatic impact on cancer care. Through her work, Dr. Mitchell has demonstrated the importance of community service and outreach especially to those individuals who may not have the means to seek out more conventional medical advice.

She received a bachelor of science in Biochemistry “With Distinction” from Tennessee State University and her medical degree from the Medical College of Virginia in Richmond. Dr. Mitchell entered active duty after completion of her internship and residency in Internal Medicine at Meharry Medical College and a fellowship in Medical Oncology at Georgetown University. She is now a retired Brigadier General from the United States Air Force.

Dr. Mitchell’s research in pancreatic cancer and other gastrointestinal malignancies involves new drug evaluation and chemotherapy, development of new therapeutic regimens, chemoradiation strategies for combined modality therapy, patient selection criteria and supportive care for patients with gastrointestinal cancer.

She travels nationally and internationally teaching and lecturing on the treatment of gastrointestinal malignancies.

As a distinguished researcher, she has received numerous Cancer Research and Principal Investigator Awards, and serves on the National Cancer Institute Review Panel and the Cancer Investigations Review Committee.  She has also authored and co-authored more than 100 articles, book chapters, and abstracts on cancer treatment, prevention, and cancer control.



Dr. Edith Mitchell attends National Summit on Health Disparities, Hon. Nancy Pelosi and Sen. Harry Reid honored

Edith Mitchell, M.D., clinical professor of Medicine and Medical Oncology at Jefferson Medical College of Thomas Jefferson University, attended the 8th Annual National Summit on Health Disparities Meeting & Awards Dinner in Washington, D.C., on April 11 and 12.

Dr. Edith Mitchell and Hon. Nancy Pelosi at the National Summit on Health Disparities. Photo Courtesy of Don Baker/NMQF

The summit, organized by The National Minority Quality Forum and the Congressional Black Caucus Foundation, in collaboration with the CBC Health Braintrust, brings together members of congress, senior healthcare executives, clinicians, payers, and allied members of the healthcare industry to discuss solutions to disease disparities.

Four consummate Americans were honored for their deep commitment and contributions in the area of health care, including Senator Harry Reid and Former Speaker Nancy Pelosi, who both received the Lifetime Achievement Award.

Dr. Mitchell moderated the “Cancer Biomarkers, Clinical Trials, & New Treatment Options” session, which included Roy Herbst, M.D., Ph.D., Chief of Medical Oncology, Yale Cancer Center and Joseph Sparano, M.D., Associate Chairman, Department of Oncology, Montefiore Medical Center.

Francis Collins, M.D., PhD, Director of the National Institutes of Health, also gave a special address.

The National Minority Quality Forum is a non-profit healthcare research and educational organization dedicated to the elimination of health disparities.